Each year brings more than 4,000 new cases of end-stage kidney disease (ESKD)—also known as kidney failure. Unfortunately, Black people are well represented in that number. Black Americans are three times more likely than Whites, and Hispanics are nearly 1.5 times more likely than non-Hispanics to develop ESKD.
Moreover, Black people tend to have higher rates of diabetes and high blood pressure, the two leading causes of kidney disease. Other risk factors for kidney disease include heart disease and a family history of kidney failure. Kidney failure treated with dialysis or a kidney transplant is referred to as end-stage kidney disease.
The kidneys use a system of delicate blood vessels to filter urine—getting rid of waste material while keeping nutrients and other cells that you need. When, as a result of diabetes, the kidneys are working harder to eliminate ketones—a type of acid, and excess glucose, those tiny vessels can be damaged.
Often there are no symptoms of kidney damage until you have lost 50 percent of your kidney function. This means your kidneys may be getting weaker and weaker without you realizing it. Eventually, your kidneys cannot keep up with the needs of the body. Once at this stage, you will require dialysis or a kidney transplant to stay alive. Also, if you have symptoms of kidney disease, they are not specific. The first symptom is often fluid buildup. Other symptoms of kidney disease include loss of sleep, poor appetite, upset stomach, weakness, and difficulty concentrating.
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If you have diabetes and kidney disease, you are at extremely high risk of kidney failure, heart attack, stroke, and death. The good news here is, we now have an effective way to reduce that risk. Recently the FDA approved canagliflozin as a new treatment to reduce the risk of ESKD and heart attack in people with type 2 diabetes and chronic kidney disease. It is the first new treatment for diabetes-related kidney disease to be approved by the FDA in decades. But canagliflozin is not a new drug; it was first FDA approved in 2013 for the treatment of type 2 diabetes.
Canagliflozin is in a class of medications called sodium-glucose co-transporter 2 (SGLT2) inhibitors. It lowers your blood sugar by causing the kidneys to get rid of more glucose in the urine. SGLT2s are proteins found in the kidneys that are important in helping the kidneys put glucose back into circulation.
You can also play an active role in avoiding or delaying kidney failure. The best thing you can do is control your blood pressure. A healthy lifestyle, including physical activity and a heart-healthy diet, can help to normalize blood pressure and also slow kidney disease. When lifestyle changes aren't enough, your doctor may prescribe medications to reduce blood pressure, control blood glucose, and lower your cholesterol.
Your doctor can detect early stages of kidney disease with routine blood and urine tests. Everyone with diabetes should have these tests at least once a year. Don’t wait to take the first step to keep your kidneys healthy. Talk to your health care provider about your kidneys today.
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Constance Brown-Riggs, is a registered dietitian, certified diabetes educator, national speaker and author of the Diabetes Guide to Enjoying Foods of the World, a convenient guide to help people with diabetes enjoy all the flavors of the world while still following a healthy meal plan. Follow Constance on social media @eatingsoulfully
